Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, associated Institute of University of Basel, Switzerland, Socinstrasse 57, 4051 Basel, Switzerland.
J Epidemiol Community Health. 2012 Jul;66(7):e22. doi: 10.1136/jech.2010.128397. Epub 2011 Oct 19.
Men appear to benefit more from being married than women with respect to mortality in middle age. However, there is some uncertainty about gender differences in mortality risks in older individuals, widowed, divorced and single individuals and about the impact of living arrangements.
Longitudinal data with 1990 census records being linked to mortality data up to 2005 were used (Swiss National Cohort). The sample comprised all residents over age 44 years in Switzerland (n=2,440,242). All-cause mortality HRs for marital status and living arrangements were estimated by Cox regression for men and women and different age groups with adjustment for education and socio-professional category.
The benefit of being married was stronger for men than for women; however, mortality patterns were similar, with higher mortality in divorced and single individuals compared with widowed individuals (<80 years). After adjustment for living arrangements, the gender difference by marital status disappeared. Stratification by living arrangement revealed that mortality risks were highest for 45-64-year-old divorced (HR 1.72 (95% CI 1.67 to 1.76)) and single men (HR 1.67 (95% CI 1.63 to 1.71)) who lived alone. In women of the same age, the highest mortality risk was observed for those who were single and living with a partner (HR 1.70 (95% CI 1.58 to 1.82)). In older age groups, the impact of marital status decreased.
Evaluation of living arrangements is crucial for identifying and explaining gender differences in mortality risks by marital status. The impact of living alone and living with a partner seems to be different in men and women.
男性在中年时期的死亡率似乎比女性更受益于婚姻。然而，对于老年人、丧偶、离婚和单身个体的死亡率风险以及生活安排的影响，存在一些不确定性。
使用纵向数据将 1990 年人口普查记录与 2005 年之前的死亡率数据进行链接（瑞士国家队列）。样本包括瑞士所有 44 岁以上的居民（n=2,440,242）。对男性和女性以及不同年龄组的所有原因死亡率 HRs，通过 Cox 回归进行了婚姻状况和生活安排的估计，并调整了教育和社会职业类别。
与女性相比，男性的婚姻益处更强；然而，死亡率模式相似，与丧偶者相比，离婚和单身个体的死亡率更高（<80 岁）。在调整生活安排后，婚姻状况的性别差异消失。按生活安排分层显示，45-64 岁独居的离婚（HR 1.72（95%CI 1.67 至 1.76））和单身男性（HR 1.67（95%CI 1.63 至 1.71））的死亡率风险最高。在同一年龄的女性中，单身且与伴侣同住的女性的死亡率风险最高（HR 1.70（95%CI 1.58 至 1.82））。在年龄较大的年龄组中，婚姻状况的影响下降。
评估生活安排对于确定和解释婚姻状况对死亡率风险的性别差异至关重要。独居和与伴侣同住的影响在男性和女性中似乎不同。
